Division of Neurosurgery, David Geffen School of Medicine, University of California at Los Angeles (UCLA), 10945 Le Conte Avenue, Room 2120, Los Angeles, CA, 90095, USA.
J Neurooncol. 2012 Aug;109(1):129-35. doi: 10.1007/s11060-012-0877-5. Epub 2012 May 27.
This report shows the results of stereotactic radiation therapy for progressive residual pilocytic astrocytomas. Medical records of patients who had undergone stereotactic radiation therapy for a progressive residual pilocytic astrocytoma were reviewed. Between 1995 and 2010, 12 patients with progression of a residual pilocytic astrocytoma underwent stereotactic radiation therapy at UCLA. Presentation was headache (4), visual defects (3), hormonal disturbances (2), gelastic seizures (2) and ataxia (1). MRI showed a cystic (9), mixed solid/cystic (2) or solid tumor (1); located in the hypothalamus (5), midbrain (3), thalamus (2), optic chiasm (1) or deep cerebellum (1). Median age was 21 years (range 5-41). Nine tumors received stereotactic radiotherapy (SRT). Three tumors received stereotactic radiosurgery (SRS), two of them to their choline positive regions. SRT median total dose was 50.4 Gy (40-50.4 Gy) in a median of 28 fractions (20-28), using a median fraction dose of 1.8 Gy (1.8-2 Gy) to a median target volume of 6.5 cm(3). (2.4-33.57 cm(3)) SRS median dose was 18.75 Gy (16.66-20 Gy) to a median target volume of 1.69 cm(3) (0.74-2.22 cm(3)). Median follow-up time was 37.5 months. Actuarial long-term progression-free and disease-specific survival probabilities were 73.3 and 91.7 %, respectively. No radiation-induced complications were observed. Stereotactic radiation therapy is a safe and effective modality to control progressive residual pilocytic astrocytomas. Better outcomes are obtained with SRT to entire tumor volumes than with SRS targeting choline positive tumor regions.
这份报告展示了立体定向放射治疗进展性残留毛细胞星形细胞瘤的结果。我们回顾了在 UCLA 接受立体定向放射治疗进展性残留毛细胞星形细胞瘤的患者的病历。1995 年至 2010 年期间，有 12 名残留毛细胞星形细胞瘤进展的患者在 UCLA 接受了立体定向放射治疗。表现为头痛（4 例）、视力障碍（3 例）、激素紊乱（2 例）、发笑性癫痫发作（2 例）和共济失调（1 例）。MRI 显示囊性（9 例）、混合性实性/囊性（2 例）或实性肿瘤（1 例）；位于下丘脑（5 例）、中脑（3 例）、丘脑（2 例）、视交叉（1 例）或小脑深部（1 例）。中位年龄为 21 岁（范围 5-41 岁）。9 例肿瘤接受了立体定向放射治疗（SRT）。3 例肿瘤接受了立体定向放射外科治疗（SRS），其中 2 例针对胆碱阳性区域。SRT 中位总剂量为 50.4 Gy（40-50.4 Gy），中位分割剂量为 28 次（20-28 次），中位分割剂量为 1.8 Gy（1.8-2 Gy），中位靶体积为 6.5 cm（3）。（2.4-33.57 cm（3））SRS 中位剂量为 18.75 Gy（16.66-20 Gy），中位靶体积为 1.69 cm（3）（0.74-2.22 cm（3））。中位随访时间为 37.5 个月。长期无进展生存率和疾病特异性生存率的累积概率分别为 73.3%和 91.7%。未观察到放射性并发症。立体定向放射治疗是控制进展性残留毛细胞星形细胞瘤的一种安全有效的方法。与 SRS 靶向胆碱阳性肿瘤区域相比，SRT 对整个肿瘤体积的治疗效果更好。
